Search term Donald F. Lynch, Jr, MD.
Такова была формула ответа. Ему приходилось слышать ее столь часто, что она совсем потеряла какой-либо смысл,-- так, набор звуков, лишенных значения.
Female Urethral Carcinoma The female urethra is largely contained within the anterior vaginal wall. In the adult it is 2 to 4 cm in length. Distally, it is lined with stratified squamous epithelium, changing to stratified or pseudostratified columnar epithelium more proximally. At the bladder neck, the mucosa is transitional cell epithelium. The histopathology of female urethral cancer depends upon the tissue of origin.
Female Urethral Carcinoma
Transitional cell carcinoma and adenocarcinoma are next most common and occur with roughly equal frequency. Unlike penile cancers, tumor grade does not appear to influence either propensity for metastasis or prognosis.
Female urethral cancers occur more often in white women than in black women. The lymphatic drainage of the distal urethra and labia is to the superficial and deep inguinal nodes.
Jump to navigation Jump to search Metastaza constă în răspândirea cancerului de la un organ sau parte la un alt organ sau parte care nu este în vecinătatea imediată cu partea bolnavă. Din înmulțirea lor rapidă rezultă inevitabil și erori, celulele modificate, care sunt depistate de sistemul imunitar al organismului și înlăturate.
The proximal urethra drains malign cancer med metastases the nodes of the iliac, obturator, presacral, and para-aortic lymphatic chains. Metastases to distant sites—liver, lung, brain and bone—occur late and are more common with adenocarcinomas.
Roughly half of tumors involve the entire length of urethra at diagnosis. A rare variation of urethral cancer is carcinoma arising in a urethral diverticulum. These tumors are usually squamous carcinomas and are usually located in the distal two thirds of the urethra.
They have been reported more frequently in black women than in white women, and likely arise from remnants of wolffian or mullerian ducts or ectopic cloacal epithelium.
Distal urethral or anterior lesions usually present early and are diagnosed while at low stage. These tumors have been successfully managed with local excision, transurethral resection, partial urethrectomy, and fulguration or ablation with either neodymium:YAG or CO2 laser techniques. More proximal lesions present later and at higher stage than distal lesions. For superficial tumors, transurethral resection or laser surgery may be appropriate.
Inguinal node dissection should be performed in the presence of palpably enlarged nodes, and pelvic node dissection should be performed when proximal involvement of the urethra is identified. There does not appear to be any therapeutic advantage to prophylactic node dissection when the inguinal nodes are not enlarged.
Radiation Therapy Radiation therapy, administered as both external beam radiation and brachytherapy, has been used for definitive treatment of both localized and advanced tumors.
It has also been used to downsize tumors before definitive surgical intervention. Chemotherapy and Combined Therapy The rarity of these tumors has precluded much meaningful clinical research in chemotherapeutic treatment, or in chemotherapy combined with radiation or surgery. Combination chemotherapy in conjunction with radiation malign cancer med metastases surgery has produced promising outcomes in squamous carcinomas of the head and neck, anus, and penis, and may be malign cancer med metastases to demonstrate similar benefit in squamous cancers of the urethra.
However, multinational, multiinstitutional trials are required to provide clinical data to assess the efficacy of any such treatment regimens. Prognosis Long-term survival is related to the stage of the tumor at the time of diagnosis and appears to be independent of tumor histology or grade. Patients with tumors of the anterior or distal urethra had better survival than those with more proximal lesions, apparently because their tumors presented earlier in their clinical course.
Beginning distally, the penile urethra is comprised of the meatus and fossa navicularis which is lined with stratified squamous epithelium.
The pendulous urethra extends from the proximal fossa navicularis to the suspensory ligament of the penis, where it then becomes the bulbar urethra between the ligament and the urogenital membrane. These areas are lined with stratified or pseudostratified columnar epithelium as is the short 1.
Holland-Frei Cancer Medicine. 6th edition.
This contains the external sphincter which is comprised of striated muscle fibers. The prostatic urethra passes through the malign cancer med metastases and is lined with transitional cell epithelium.
The remainder occur predominantly in the fossa navicularis. Infrequently, transitional cell carcinoma or detoxifierea ficatului la copii tumor may predominate at the bladder neck or within the prostatic urethra. Poorly differentiated transitional cell cancers may show some squamous characteristics.
Abstract Aim: Malignant tumors localized in the digestive tract have a tendency to local growth and invasion with lymph node metastasis. Distant metastases through blood with prevalent liver location are detected late in disease progression, in an advanced stage, when therapeutic possibilities are often limited to palliative therapy. Material and methods: The study included a series of patients with liver metastases admitted to the Center of Gastroenterology and Hepatology Iasi between January 1 and Malign cancer med metastases 10, for the identification of primitive tumor. The patients were investigated by endoscopy, imaging, laboratory tests including tumor markers.
Rarely adenocarcinoma may arise in the glands of Littre or the prostatic utricle. Metastases from distant tumor sites to the penis also occur infrequently. Figure Retrograde urethrogram demonstrating squamous carcinoma of bulbous urethra associated with a stricture.
Carcinoma of the Urethra - Holland-Frei Cancer Medicine - NCBI Bookshelf
Obstructive symptoms are common in more proximal lesions, while urethral bleeding malign cancer med metastases palpation of a mass herald more distal lesions Figure In general, the more proximal a tumor, the later in its development and the higher its stage at diagnosis. Four-color version of figure on CD-ROM Malign cancer med metastases special case exists in the urethral segment which is retained following cystectomy.
These tumors are almost exclusively transitional cell carcinomas. Monitoring of the urethra in this situation and management of these tumors is discussed elsewhere. Lymphatic drainage of the distal male urethra is similar to that of penile tumors. Tumors of malign cancer med metastases fossa and pendulous urethra drain to the superficial inguinal lymph nodes, while tumors of the bulbar, membranous, and prostatic urethral segments drain to the iliac, obturator, and presacral node groups.
There may be crossover at the prepubic lymphatic plexus.
Surgical Management Low-grade, low-stage tumors of the urethra may lend themselves to transurethral resection or laser fulguration, but such lesions are rare. Excisional biopsy may be feasible, and biopsy prior to laser fulguration is essential to assess histopathology and tumor depth.